Detail by Officer/Registered Agent Name

Florida Not For Profit Corporation

PHYSICIANS CHOICE IPA, INC.

Filing Information
N96000002105 N/A 04/17/1996 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 09/22/2000 NONE
Principal Address
% DR B. DAVIS
951 NW 15TH ST #2A
BOCA RATON, FL 33486

Changed: 09/12/1997
Mailing Address
% DR B. DAVIS
951 NW 13TH ST #2A
BOCA RATON, FL 33486

Changed: 09/12/1997
Registered Agent Name & Address FIELDS, GARY D
4400 PGA BOULEVARD
SUITE 700 - ADMIRALTY TOWER
PALM BEACH GARDENS, FL 33410
Officer/Director Detail Name & Address

Title SD

BLANCO, JACK M.D.
951 N.W. 13TH STREET
BOCA RATON, FL 33486

Title D

BREUER, NICOLAS RM.D.
1000 N.W. 9TH COURT, SUITE 102
BOCA RATON, FL 33486

Title D

DAVIS, BARRY M.D.
951 N.W. 13TH STREET
BOCA RATON, FL 33486

Title CD

GELFMAN, CHARLES M.D.
801 MEADOWS ROAD
BOCA RATON, FL 33486

Title PD

HEVERT, DAVID BM.D.
900 GLADES ROAD, 4TH FLOOR
BOCA RATON, FL 33431

Title TD

PROSCIA, VITO M.D.
1001 N.W. 13TH STREET
BOCA RATON, FL 33486

Annual Reports
Report YearFiled Date
1997 09/12/1997
1998 02/10/1998
1999 05/08/1999